This MOOC is the first of its kind, since it addresses critical issues related to drugs from a multidisciplinary, health and human rights-based approach. Throughout the course you will cover a range of questions including what are drugs and why they controlled? What are the benefits and harms of taking drugs? How public health policies can address drug use?
You will also learn about the intricacies of the international drug control framework and the negative consequences of widespread prohibitionist drug policies around the world. Finally, you will examine ways of furthering drug policy reform.
The topics will be presented by over 40 speakers from scientific, academic and institutional backgrounds, spokespersons of civil society as well as people who use drugs presenting their views.
By the end of the course you will have:
- a strong understanding of the major health issues related to drug use and drug policy;
- a clear vision of why drug policy is debated today;
- and, if you so wish, you will be equipped to engage in the drug policy reform movement at your local or regional level.

Avis

MW

Thanks so much for a very good course,more informative by myself..work hard for it\n\nbecause got a little bit trouble with my language competency.But it's good to take a class.

PH

Jul 20, 2019

Filled StarFilled StarFilled StarFilled StarFilled Star

Excellent course! It changed my mind!\n\nBefore I had no comparable knowledge!

À partir de la leçon

MODULE 5: Medical access to opioids for the management of pain and to other controlled medicines

Welcome to Module 5 which looks at access to controlled medicines. During this week, you will learn how the international scheduling of drugs works; be presented with some of the main barriers to access to essential medicines and look specifically at the case of the opioid epidemic which is ravaging through the United States at the moment. The medical use of cannabis and cannabinoids is also a highlight of this week and one that is particularly relevant in a number of countries around the world at present. By the end of this Module you will be able to: • Describe the scheduling of controlled medicines; • Recognize the barriers to access to controlled medicines and discuss the challenges posed by prescription drugs epidemics; • and examine the current issues around the medical use of cannabis and cannabinoids. We hope you enjoy this week, which is slightly different to the other Modules in terms of its specific topic but adds a lot of important information in terms of understanding the international drug control framework and issues related to drugs, drug use and policies as well as possible. Best wishes,The Drugs, Drug Use, Drug Policy and Health team

Enseigné par

Michel Kazatchkine

Senior Fellow

Barbara Broers

Professor (in Addiction Medicine)

Jennifer Hasselgard-Rowe

Researcher and Lecturer

Aymeric Reyre

Senior Lecturer

Transcription

I'm Ethan Nadelmann, I'm founder and the former Executive Director of the Drug Policy Alliance, which is a leading organization in the United States, advancing alternatives to the war on drugs. One of the issues that we've been dealing with for many years has been the growing problem of overdoses, involving overdose fatalities, involving opioids, both illegal, like heroin, as well as pharmaceutical opioids that may be prescribed by a doctor or diverted from illegal markets. Now, when I say overdose, I should be clear. Most of what are called overdose are, in fact, better defined as fatal drug combinations, because the large majority of people who die when they take an opioid, it's not from taking that opioid alone, unless it's one of the new very powerful synthetics like fentanyl. Most of the overdose fatalities involve a combination of opioids with alcohol or with benzodiazepine type drugs. So the better language would be to say, fatal drug combinations. But whatever you call it, it's become a monumental problem within the United States. In the most recent years, more people are dying of opioid overdoses than are dying in auto accidents, more than are dying in gun homicides. It has become, from recent years, the number one cause of accidental death in the United States. Now, this is a problem that's somewhat unique to the United States. In Canada, not as big a problem in Europe. So, one has to ask the question, why is this happening? In some respects, in the United States, we've had sort of a perfect storm, where five or six variables are all coming together to make this the crisis that it is. Firstly, you have the consumer. You have a large number of Americans who are experiencing some forms of pain, very intense pain and chronic pain. We live in a "pill-popping" culture. People want that pill to take away their pain. They go to doctors demanding that. They watch commercials advertising these things. Secondly, you have the medical practitioners, the doctors and nurses, they are confronted with a patient who's in pain. These medical practitioners are oftentimes not well-educated in issues of pain and pain management. They may be generalists, they may not understand the proper role, they want to give the patient what that patient wants, especially when they're in need. In the American Medical System, there's not a lot of time for a doctor or nurse to listen to the patient to find out what's going on and oftentimes, the simplest, quickest thing to do is to prescribe the opioid medication. Thirdly, you have the insurance companies. Well, for insurance companies, giving a choice between paying for large numbers of opioids to be prescribed to patients, which may not cost as much money, versus paying for these sorts of behavioral interventions and alternative treatments that may be most effective in dealing with chronic pain. Well, from that fiscal financial perspective, the insurance companies may be exacerbating this crisis. Fourthly, you have the pharmacists whose job it is to hand over their medication. Well, 100 years ago, pharmacists exercised more judgment in the American Medical System. Now, they've essentially been relegated to the sidelines, where essentially all their job is, is to hand over the pills without really asking very much question and very much in the way of questions. Then, of course finally, you have the manufacturers and the distributors who want to make as much money as possible without getting too much grief for it. So, they have a huge incentive to keep shipping these pain killers out. So the pain killers that were really meant to deal with acute pain, people coming out of post-operative surgery, people who had just been burned, people dealing with the pain of terminal cancer. The medications that can be miracle drugs for those types of pain turn out to be not very effective, but usually in demand for dealing with chronic pain. Put all that together, it helps explain why we have this big crisis. But I think there's another issue going on here, which is that, we're suffering not just from an epidemic of opioid use and opioid misuse and overdose. I think in the United States, we're suffering from an epidemic of pain, and that pain is not just physical pain. It's also psychological and emotional pain, spiritual pain, and even existential pain that oftentimes manifest as physical pain. For those sorts of pains, opioids don't work all that well, but it's the thing that people know, the thing that people feel that they want. Now, why is that happening in our culture at this time? That's a bigger more difficult question. Some of it has to do in the ways with which that our medical system, our insurance system, or pill-popping culture has encouraged that type of mentality. Some of it has to do with the growing element of despair. It's fascinating. When you look at those counties in America that are suffering some of the worst crises with opioid misuse, and you look at those counties that voted most significantly for Donald Trump, and especially the counties that previously voted for Obama four or eight years ago, kind of white declining working class communities that feel sort of lost and hopeless in America, those are the groups that you see with massive levels of opioid addiction and massive levels of support for Donald Trump. Both of them are expressions of some existential anxiety and fear about their lives and their nation.